Fracture Liaison Services

Baroness Bull Excerpts

Thursday 16th October 2025 Grand Committee

[Baroness Bull (CB)]

My Lords, I declare my interest as an ambassador for the Royal Osteoporosis Society, and I congratulate the noble Lord, Lord Black of Brentwood, on securing this important debate. Since the campaign for universal access to fracture liaison services was launched, I have seen osteoporosis evolve from an issue oft overlooked in public policy to one that now enjoys cross-party support, with the noble Lord a doughty and persistent champion. Every party endorses the importance of universal fracture liaison services: they are in Labour’s 10-year plan for health, the Conservative manifesto, the Liberal Democrat manifesto and even in the policies of the Reform Party.

However, despite this almost unique level of consensus meaning this should have been an open goal, yet somehow the ball has been lost in kerfuffle and confusion. The confusion is not about intent or even value. Everyone agrees that universal fracture liaison services will save lives and money, but communication between different parts of the system has broken down. The Royal Osteoporosis Society, Ministers, NHS England and local commissioners and indeed the extensive list of networks and organisations that we heard about earlier are all working towards the same goal, yet they seem to be doing so on different pitches. The proposal, for instance, to include fracture liaison services in neighbourhood health centres could one day prove valuable but, as an idea, it was poorly communicated and has just led to greater uncertainty. Commissioners are now unsure whether they should act locally or wait for a national steer and, as a result, progress has stalled.

We know that Ministers face multiple pressures and competing priorities, but a clear commitment was made, and those who fought for it need to see that it still stands. What we need now is to convert confusion into clarity so that we can harness the current consensus to drive change. Commissioners, clinicians and patient groups all need to understand what is expected of them and when. A straightforward statement from the Government that sets out responsibilities, timelines and how the FLS rollout fits within the 10-year plan and neighbourhood health centre programme would resolve much of the current uncertainty.

There is no shortage of evidence to support the case for universal FLS and no shortage of the will and expertise necessary to make it happen. The obstacle is obfuscation. A clear statement from government, followed up by collective action to get everyone on the same page would translate the current confusion into clarity. As we have heard, if the Minister can make that happen before Christmas, we could turn the broad agreement into real delivery.